There are several manufacturers of laparoscopic surgical devices for tubal ligation. These devices generally utilize a hollow plastic tube containing a pre-formed loop of suture material with a slip knot at the terminal end. The other end of the suture terminates in a plastic handle or puller which allows easy application of traction to the device to close the loop around the tissue to be ligated inside the patient's body. A tapered distal end on the plastic tube forces the closure of the slip knot as the surgeon applies pressure to the puller causing strangulation of the tissue within the loop. Once the strangulation is sufficient to satisfy the surgeon utilizing the device, scissors are inserted through another trochar and excess suture material is cut-off adjacent the slip knot.
These devices have proven particularly helpful in endoscopically ligating blood vessels, appendix stumps and similar structures. Suture material used in the devices includes both absorbable suture material such as cat gut and non-absorbable suture materials such as silk. Other proprietary types of suture material have also been used.
The disadvantages of these devices is that at least two additional portals, formed with trochars, are required. One is for viewing via a laparoscope and the third portal is for providing a surgical clamp and/or surgical scissors. The laparoscope is used to visually monitor the procedure being done. A surgical clamp is used to grasp the tissue to be ligated by the suture loop and the scissors are used to cut away excess suture material after the ligation has been completed.
The following patents are exemplary of the prior art:
Komiya, U.S. Pat. No. 4,018,229, shows a rather complex tool for internally attaching a loop and securing it around an affected part in a coeloma.
Shannon et al. U.S. Pat. No. 3,476,114; Mulhollan et al., U.S. Pat. No. 4,602,635, and Ferguson et al., U.S. Pat. No. 3,877,434, each show ligating instruments used to tie a knot to secure the structure being held.
West German Patent No. 2,804,070 and USSR Patent No. 552,077 also show ligature knot tying devices.
Takamatsu, U.S. Pat. No. 4,487,489, shows an endoscope having an electrode loop for clamping a tissue. The endoscope also includes means for viewing the operative site.
Wheeler, U.S. Pat. No. 4,607,621, discloses an endoscopic device utilizing a loop for extending around a body tissue and has an electrode plate upon which the patient rests during the operative procedure for completing an electrical path. The endoscope also has viewing means.
Thus, while the foregoing patents are suitable for their intended purpose, they do not overcome the disadvantages set forth above.